Monday, July 25, 2016

Training on Empty: Chapter 18

Chapter 18 – The Stress of It All

“All glory is fleeting.” – George Patton

There’s no doubt that competitive running can be stressful. It is physically and mentally challenging and there’s an enormous amount of pressure in any running event to give it your all. Running a race entails laying everything on the line and stepping up your game to see whether or not it’s in you to go past your limitations, be they physical or mental. Any weakness is exposed for all to see, and you can be left feeling quite vulnerable out there in just a pair of running shorts and a singlet.

In contrast to countries where running is a way of life, running here in the United States is often regarded with skepticism. When I was younger, running was nowhere near as popular as it is today, and I often got strange looks from the people I ran by on the trails. In a way, this added to the pressure for me to run well, because there were so few people who considered running something people did to enjoy themselves. It made more sense to run if I could defend the activity by explaining that I was training to race, was preparing to compete, and could beat just about anyone. As a result, I was always in training, never really taking time off to regroup. I went from track in the spring to road racing and mountain racing in the summer. Then, I continued from mountain racing to cross-country in the fall, and finished out the year with a few indoor track meets and more road racing during the winter.

My high school was already a high-pressure environment. It was considered one of the top schools in the state not only in athletics but also in academics. Going to school, racing and having an eating disorder were, in a sense, like having three full-time jobs. It’s no wonder my body and mind grew tired. In the summers I had one less stress by not having to worry about school, but the other two stresses were still there and growing stronger all the time.

In addition to the general stress of running, my body was exposed to an enormous amount of additional stress because of my poor running form. Unlike many other good runners, I was a “toe runner,” meaning that I landed on my forefoot rather than on my midfoot. This made me injury-prone and also made it so that I had to work harder than other runners in my ability range to secure the same results. My racing style was entertaining for spectators, because I never started out in the front. Instead, I often had to come from behind and make a bold move in the middle of the race, passing the others to gain the lead. From there, it was a matter of stretching the lead as much as possible to avoid having to kick at the end. I could turn out 82-second quarter mile pace until the cows came home, ate their hay and went to sleep, but I couldn’t run much faster than that if my life depended on it! My coach told me that the end of the race would always take care of itself; I knew that no matter how tired I was at the end I would give it my all to cross the finish line first. Our strategy for shorter races like the mile was to run the third lap as if it were the last and hang on to the end. Typically, the third lap of a mile race is the slowest, so it’s mentally challenging to push that lap. It was crucial to get as large a lead as possible, so essentially I had to work at peak effort for the entire race.

Despite my less-than-perfect form I was obviously able to hold my own. Often, I think, it was sheer superior determination that got me to the finish line first. I had a horrible upright posture that, again, was not ideal running technique by any means. Everyone around me felt I would be a better runner if I could have had more of a forward lean. My form led me to run with a short stride, so I had to make up for it by having a quick rhythm, or turnover. Unlike the girls who had long strides and nearly perfect foot landing, a combination that naturally propelled them forward with each stride, I was forced to concentrate on pushing harder and being mentally tough. Adverse conditions were my forte. Rain, mud, wind and snow didn’t scare me, and indeed were things I thought gave me an edge.  
In a sense, I was the perennial underdog. Even when my name started to be recognized in the running world, my come-from-behind technique tended to excite the crowd, making it seem as if each win I racked up was unexpected. I worked on my form all through school. I practiced downhill running in order to get the feel of leaning forward more, and worked on drills to keep my knees up in front and then kicking my heels up in back, The irony was that my incorrect road racing and track form that I worked so hard to change was perfect for uphill running. I could take a more natural comfortable stride when I raced in the mountains. In addition, the soft trails were far less brutal on my body than the track or the roads. In the mountains I felt as if I could run forever. Eventually, though, even mountain running would be difficult and painful.

As much as I loved mountain running, I loved the roads and even the track as well. I just loved to run period. The stronger I became as a runner, the more I was willing to take risks and push myself, entering the elite division in major races rather than the open or junior division. Again because of my poor form, I had difficulty in road races, especially longer ones. Being a toe runner put enormous pressure on my feet. I was always at risk for stress fractures. In longer races I was constantly dealing with blisters, because instead of boasting the optimal heel-to-toe roll runners covet, I landed hard on my forefoot, causing great friction and a braking effect every time I landed.

In one 10k race, I entered the elite division and found myself running against 1984 Olympic Marathon Silver medalist Rosa Mota and other internationally recognized runners. Though I was a great warm-weather runner, having set a course record in the Diet Pepsi 5k in Denver in 97-degree heat the year before, this race would be different. By mile four,  my feet were so riddled with blisters that I had to run in the middle of the road to avoid anything other than flat, even surfaces, as the slightest camber in the road caused more pressure on my feet. I took my turns extra-wide but was still in great pain with every corner. In the end, a sizable fraction of the elite field had dropped out, the stifling weather too much to bear. I finished in well under 40 minutes but also far off my anticipated time of 36 minutes. My feet suffered for days after, and I could hardly walk until the blisters started to heal.

Unfortunately, by the time I was in my later years of college, I was beginning to show signs of arthritis and stiffness. My lower back and hips were constantly sore, and no matter how hard I tried, I couldn’t seem to find a comfortable stride. I would become so sore after races that easy cool-down jogs were painful. I often found myself limping the next day as well. It seemed that while I had jumped into the spotlight as a young athlete, I was slowly starting to slip off the stage. As my races became less impressive and the pain got harder to manage, I found that fans who hadn’t seen my name in the paper for quite some time would often come up to me and ask the standard question: “Are you still running?”

During the times I was running well, I felt as if I were making some kind of real impact on the world, changing it or opening a door somehow. I never ran for the fame or the glory. It was always something that seemed almost beyond me, a driving force, yet there was a part of me that hoped I would do something memorable one day, something great. I thought perhaps my destiny would be reaching the Olympics or traveling to Europe to compete among the world’s best mountain runners. Ultimately, no matter what event I settled on, I hoped to set a record that wouldn’t be broken. “Records are made to be broken” never resonated with me – until, of course, many years later, when my own records started to fall.

In 2005, a local newspaper held a poll to determine the number-one athlete in Colorado history. I didn’t hear about the poll until a friend called me and told me she saw my name in the paper. According to this poll, I was ranked 18th on the “all-time best high-school athletes ever in Colorado” list. The girl who deservedly won, Melody Fairchild, was also a runner who had broken most of my course records several years after I had graduated from high school. She attended Boulder High, naturally a rival school of Fairview. Though my school records still stand today, one girl who attended Fairview and ran cross-country years later was ranked above me on the list. Years after the fact, it’s rare that people remember a standout high-school athlete, at least in a sport like cross-country. New athletes come to take the spotlight in the crowd and develop a fan base. Today, most people don’t know me as a runner. At times, though, an occasional fan from the past will say, “hey, aren’t you Lize Brittin, the runner?”  When I hear this, it makes me cringe just a little to remember all the pain I went through during my competitive running career, but I have to smile at the thought of somebody actually remembering my hard efforts. It’s touching.

Though there are some runners who may stand out on a small scale, it’s uncommon for runners to be recognized to the same extent as other athletes. It’s a rare that someone like Steve Prefontaine comes along, a runner so brave and strong that people remember not only the great races of his time, but the brash manner in which they were run. Frank Shorter and Grete Waitz both have had statues made of them, but unfortunately it’s uncommon for distance runners to be well-remembered. Maybe with the increased interest in running in the early part of the 21st century, that will change.

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Training on Empty: Chapter 17 (Possible TW)

Possible trigger warning with mention of behaviors and numbers.

Chapter 17 – My Secret

“Success is not measured by what you accomplish but by the opposition you have encountered, and the courage with which you have maintained the struggle against overwhelming odds.” – Orison Swett Marden

I never told my coach about my problem with food. I kept it a secret from nearly everyone except my family, and that was only because my sister caught me throwing up in the sink after sneaking into the kitchen early one morning to binge and purge on ice cream, something I did when I was feeling either extremely stressed out, overly tired or hungry when I didn’t want to be.

My coach agreed to take me back on the team, and we started a training program to get me back in shape to race. Soon I began running a little bit at a time. My pelvis was holding up nicely. No more sharp pains plagued me, and I could walk with a normal gait again. I had missed my junior season of track, but summer was approaching and I knew I could train in the mountains with the team to get ready for my last year of high school.

At my first big cross-country race as a senior, I was terrified. I had established myself as the top runner on the team again, but my confidence was waning. There was a new girl on the running scene I had never competed against. She was solid and fast and swam varsity on her swim team in addition to running both cross-country and track. Her father was a former military man and dictated all her workouts. On her supposed days off, she did pull-ups and extra sets of intervals under her father’s supervision. She eventually developed severe asthma that cropped up during and after races.

I was so nervous at the start of the race that I could hardly breathe. It seemed that no amount of yawning could fill my body with enough oxygen. My legs felt heavy and tired. I tried to keep my focus away from this new threat, but my eyes kept wandering to her warm-up movements. Just watching her, I started to have some self-doubt, wondering if I even wanted to attempt to keep up with her. She looked fast.

When the gun went off, I felt overwhelmed as I found myself in the middle of the pack. The new girl had shot out to an early lead, and I could barely even see her in the distance. I tried to keep calm in the face of rising panic over perhaps not being the runner I’d once been. Soon, however, I started to reel in the runners ahead of me and settled into gradually closing the gap between the leader and myself. Toward the end of the race I was running side-by-side with her, and all of a sudden I felt it: A switch turned on and I was back. I surged, giving everything I had, and passed number one to take the lead. As I lunged for the finish, the fire that had lain dormant throughout my injury was burning fully inside me again. I crossed the line just a few seconds ahead of second place, but that was all it took for me to know this was going to be my year.

My relationship with my coach felt strained, but I did as he asked – usually. I had learned that rest was not a bad thing. I felt it was important to take days off even though my coach was a bigger fan of easy days than complete rest days. Unfortunately, my days off would sometimes lead to binges and occasional purges as well. I constantly felt fat at just around 100 pounds. My weigh-ins caused me growing anxiety, and I sensed that my coach was concerned about me getting too fat. Originally, my coach weighed me because my parents had requested that he keep an eye on my weight.

Everyone seemed concerned that I might lose too much weight, but once my weight was over 100 pounds, I was convinced he was worried I would be too heavy. Whether this was in my head or not, I’m not sure, but I convinced myself that it was the case. In my mind, the occasional purges helped the weight stay off, but the reality is that purging rarely helps with weight loss. What purging offered me was some occasional and temporary relief from the pressure. What it took away from me was my sense of self. I was a more relaxed runner overall my senior year, and this unhealthy eating regime did not prevent me from having a stellar season, but I experienced tremendous guilt trying to hide my problem and worried excessively about how forcing myself to vomit would affect my health. Despite the terrible way in which I treated my body that year, I set a course record on every course I ran and won the state meet, becoming the first girl in Colorado to ever win states twice in a row. During the off-season I entered a few road races, among them one in which I ran an incredible 35:04 that established a new course record in the Run for the Zoo 10k in Denver. After a night of stress-related binging and purging – which in my case really meant eating what others would consider normal amounts and purging – I won the Midwestern High School Cross-Country Championships in Wisconsin and again qualified for Nationals in San Diego. I was, however, starting to feel more fatigue as the overly long season of racing dragged on. I ended up seventh at nationals and felt ready for a break. Unfortunately, track season was lying in wait, so my break was much too short.

By the time spring track season started I had already run under 11:00 for two miles indoors. There was no real indoor season for Colorado high school athletes, so my coach had me run some races at the University of Colorado all-comers meets. It was an exciting day when I broke 11:00, as my sister, who was rarely able to attend my meets due to her busy schedule at school, happened to be sitting in the stands. As our own high-school track season wore on, my general fatigue grew. I was undefeated going into the state meet, and my coach was determined to have a new state record in the two-mile for us. What should have been a walk in the park turned into a long clumsy jog around the track. My downfall actually started the day before the race; I was too fat and I knew it. I tipped the scale at a whopping 102.

Fearful of the added weight, I asked my coach if the one or two extra pounds would affect my race the next day. “It will probably slow you down,” he said. I had no idea how to take that statement. I felt so guilty that I threw up what I ate that night. I was so distressed by the time the race rolled around the following day that I ended up losing sight of my goal of setting a state record. From the gun, I got out in front and just settled. I ran comfortably. The battle in my head raged on – come on, pick it up vs. just finish the race and be done with it. About three-fourths of the way through the ordeal, in mid-stride and as I was heading into the turn, I caught sight of my coach and I knew I would soon have to face him, face myself, my fatness, my apathy and my failure. I thought about Kathy Ormsby, who in the 1986 NCAA championship meet had run off the backstretch of the track two-thirds of the way through the 10,000 meters, trailing the leader by only two or three strides at the time. She ran out of the stadium without even visibly slowing and jumped off a bridge in an attempt to kill herself. Though she ended up surviving her 40-foot fall, she lost the use of her legs and is now confined to a wheelchair. It’s a bitter irony, but as hard as it probably is for most to believe, Ormsby claims that she is happier now than when she was under enormous, self-imposed pressure and stuck in her obsessive training. By the time my foot hit the ground I felt detachment. “Fuck it, I’m tired,” I thought. I tried everything possible to pick up the pace, but had nothing to give. My body would not respond, and my mind wavered. I finished in over 11 minutes, and when I faced the man who had led me to greatness while watching my suicide, I saw the disappointment on his face. I felt like I was an absolute failure. I had won the race, yet my perception was that I totally lost in his eyes and, as a result, in my own. I still had one last race to get through in the summer – a two-mile national cross-country race. I finished fourth in another apathetic showing. I had reached full burnout at age 18.

Despite all the conflicts I had with my high-school coach, in large part I still looked up to him, even after this final race debacle. This admiration continued throughout high school and even into my college career. Shortly before I graduated from high school, I was given the chance to speak in front of the student body and faculty after winning an “outstanding athlete of the year” award. Instead of offering anything profound, I told the audience what I thought they wanted to hear and said I owed it all to my coach. While I will always appreciate the way my coach helped me achieve success in racing, today I feel sad that I was unable to acknowledge how hard I worked at the time. I also regret that I discounted the stresses my coach placed on my young shoulders. There was a part of me that felt undeserving of the attention I received, even though I had many standout moments as a runner, especially that year. This feeling likely stemmed more from my own troubled soul than from any objective lack of accomplishment.

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Training on Empty: Chapter 16 (Possible TW)

Possible trigger warning with mention of behaviors and numbers.

Chapter 16 – Males and Eating Disorders

“My theory is that men are no more liberated than women.” – Indira Gandhi

It's rare to think of a man when the topic of eating disorders comes up, but women are not the only ones who suffer. It’s much more common for men to confess to binge-eating than to any other eating disorder, but that doesn't mean that they are immune to other eating issues. Over thirty percent of binge-eaters are male. Eating disorders in general are starting to be more recognized in men, especially gay men, who make up the majority of males with eating disorders at this point or are at least more willing to admit to having one. Many gay men already worry about prejudice and discrimination as a result of their sexual orientation, and added to this burden is the fear that their peers will judge them in terms of their weight. The term “gay fat” emerged to describe a gay man who could be seen as normal in size by most, but fat in the eyes of other gay men. Within the gay culture, there is so much pressure to be perfectly toned and lean that many men are developing an abnormal focus on their bodies and falling into disordered eating patterns. Though gay men are more likely to seek treatment than men in general, they are also developing eating disorders and body dysmorphic disorder – a condition in which people become preoccupied or obsessed with a perceived flaw in their appearance – at an alarming rate. Even though gay men are more often diagnosed with eating issues, they are not the only ones affected.

Many people agree that anorexia in men may be under-diagnosed, and there are several reasons for this. Often, physicians will not recognize the illness in a man owing simply to the false assumption that anorexia is a women’s disease. According to the article “Eating Disorders in Men” by Margarita Tartakovsky, M.S., most of the diagnostic criteria for anorexia focus on women. Typically, doctors look for amenorrhea and a fear of fatness. However, men’s symptoms can differ greatly from those of women. For example, while most women report a fear of getting fat or feeling fat, men might express the desire to be more muscular and still suffer from the disorder. Just as there is societal pressure for women to conform to a certain body type, the pressure on men to look a certain way is becoming more apparent as well. Lately, there has been an increase in men seeking plastic surgery such as pectoral implants, calf implants and liposuction. More often than not, men keep quiet about their struggles with food, which leads others to assume that there isn’t a real problem or the problem is not severe. Obsessive exercise is common in men who suffer from anorexia. Because there are sports in which low body weight is acceptable, men who engage in these sports can rationalize that their low body weight is not an issue.

Dave Dunham, a renowned road, mountain and snowshoe racer and a recovered anorexic, admits that it’s often harder for men to open up about eating disorders. He says that “there is a societal expectation for men to be tougher and not really talk about problems.”

Dave’s issues began after college, when his weekly mileage was increasing and his weight was decreasing. While some people exercise in order to work off calories already consumed, Dave exercised in order to give himself permission to eat. “I started running triples – three runs a day,” he says. “I think this is when things really started to snowball. I didn't like running within a few hours of eating, so it became difficult to find a time to eat. Somewhere along the line, instead of eating to run, I was running to allow myself to eat. If I didn't run long enough or hard enough, I felt I didn't deserve to eat. Eventually, I got to the point where I was not eating, except for dinner. This kept the illusion that nothing was wrong. My doctor had been encouraging me to get help for a couple of years, but I kept saying that despite knowing I had a problem, I wasn't ready to do anything about it. At 5’7”, I was down to 115 pounds and injured when I finally decided that it was time to get help. I bottomed out weighing less than 110 pounds and finally got into an eating disorder program.” Fortunately, Dave has recovered from his illness. He no longer uses his training to feel okay about eating. To anyone struggling with an eating disorder, especially anorexia, Dave recommends throwing out the scale and eating a variety of foods.

Though reluctant to admit it, men also suffer from bulimia. When I was a young runner, I met a top mountain runner who told me years later that while he was racing and training, he had bulimia. He would not go into detail about his illness or how he eventually overcame it, but he did say that the pressure of running, racing and wanting to be thin contributed to the purging cycle.

Kevin Beck, a running coach and former sub-elite marathon runner, developed bulimia during his freshman year in college. He believed that there was such a stigma for men to admit having an eating disorder that he kept it a secret for years, though he says that he feels that he would have studiously guarded his secret even had he been female. It wasn’t until he was much older that he was able to finally confess that he had a problem despite sensing those around him, especially his mother, suspected that he had issues.

Kevin admits that the illness isolated him, chiefly in a psycho-emotional sense but sometimes literally. His social life was compromised during periods of extreme binging and purging, as for all intents and purposes he was in the throes of an addictive drug at such times. For him, bulimia became a way to cope. It was an easy “solution” to always fall back on when something seemed difficult or he got overwhelmed with emotion, good or bad.

Kevin cautions anyone struggling to talk about it with someone. Even just admitting out loud that he had a problem seemed to help. It took the power out of the illness to some extent. “I wish I had said something. It’s so shame-based,” he says. “I wish guys would be able to talk about how they feel and express when they feel isolated and emotionally burdened. It would help dissolve internal conflict.”

As far as actual symptoms, it has been reported that men and women suffer similar rates of accompanying unhappiness, anxiety, depression, self-injury and substance abuse. In addition to the bulimia, Kevin has also struggled with alcohol abuse. In general, co-existing addictions are more common in bulimics than in anorexics. Kevin attributes this to bulimics having poor impulse control, while anorexics tend to exert too much control. Samuel S. Lample, in his article “Eating Disorders: Not just a women’s problem,” reports that a study of 135 male eating-disorder patients revealed that across all diagnoses, 37% had a comorbid substance use problem, with alcohol abuse the most common problem (seen at a rate roughly three times that of cocaine abuse.) More specifically, Lample notes, 61% of patients with bulimia had a co-occurring substance abuse problem, and that they were three times more likely to have this problem than anorexic men.

In the same article, Lample suggests that those with bulimia show decreased prefrontal cortex brain activity but increased activity in the limbic system. This combination potentially leads to poor judgment and possible emotional problems. Writes Lample: “The strong food cravings common in those who binge eat, are linked to the brain's hedonic system, which regulates risk-taking and novelty-seeking behaviors, self-control, and pain avoidance. In short, bingeing behaviors can be seen as resulting from problems in the hedonic system around impulse control.”

Despite the hope that he would one day simply outgrow the illness, Kevin still struggles with it today. Bulimia has taken its toll on him both emotionally and physically. The continual throwing up throughout the years has caused his teeth to erode, and a computerized tomography (CT) scan has shown that his brain, almost certainly as a result of alcohol, resembles that of a much older person. Kevin feels that without getting to the root of his problems, he won’t be able to find better ways to cope. He can go years without binging and purging or years without drinking, only to relapse. Because Kevin understands the illness so well, he has, despite not being able to help himself, been able to offer help to others. He feels that early detection is the key to a less traumatic and more complete recovery.

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Sunday, July 24, 2016

Training on Empty: Chapter 15 (TW)

Trigger warning with mention of behaviors and numbers.

Chapter 15 – Tonya

“No one is immune from addiction; it afflicts people of all ages, races, classes, and professions.” – Patrick J. Kennedy

It has been so long since I last binged or purged that I don’t remember exactly when this was. I couldn’t have been older than 29 the last time I forced myself to vomit. However, it was an addiction that lasted off and on for close to fifteen years. I always considered myself and was considered by others to be anorexic, but I struggled with bulimia from time to time as well. Oddly, I could go several months or even years without purging, only to relapse unexpectedly.

I always tried to keep my purging in check. I never purged more than a few times a week even at my worst. It seemed I was stuck in all-or-nothing habits, taking days off and binging or running and training and eating smaller amounts. My binges were never extreme. I've read about people consuming well over 4,500 calories in a single binge session, and while I could down quite a bit of food during a binge, I never approached these enormous quantities. However, I was so afraid of gaining weight that even a little too much was loads too much in my mind. This fear of fat went much deeper than being afraid of the weight itself. Becoming fat or even gaining weight represented being unaccepted. It translated into failure in my mind, and I believed that it set a person up for instant ridicule and criticism. In spite of my great fears about my body expanding, there were times when I did outright binge.

My favorite binge food was ice cream – ice cream with anything, really: cereal, peanut butter, pretzels, cookies or chocolate chips. Ice cream went down easily and also came up easily. Another food I tended to binge on was cereal. I was often afraid of getting caught throwing up, so when the need to purge would come over me, I would grab my running shoes and head to the trails. I lived a short jog from a large network of mountain trails, so it was easy to find a tree to take cover behind so I could vomit in secret. The jog leading to these secret spots I found where I could throw up would upset my stomach and this made purging easier as well. Initially it was hard to make myself throw up. I had to stick my finger down my throat, which made my eyes water and my throat burn. But over time I could just lean over, press my arm against my stomach and make nearly anything come up.

During this time it was hard to manage my diet. I ate relatively healthy foods when I wasn’t binging and continued to train hard. Even though I didn’t purge on a daily basis, the binge-purge cycle was nearly impossible to break. Even in the throes of it, I could go a week or two without purging, but would always eventually slip again

For many reasons, binging and purging is one of the hardest addictions to give up. The pure satisfaction of stuffing the stomach with forbidden rich foods combined with the rush of feel-good chemicals to the brain after a purge is nearly impossible to overcome. Many people binge and purge as a way to deal with stress or to avoid uncomfortable feelings. As with any addiction, It’s a momentary escape from reality. Though I eventually quit the cycle, the temptation haunted me for years. It was only after the fifth year into recovery that I noticed that the temptation, even under extreme stress, was completely gone. I have met many women who have had bulimia, some of them now recovered and some still struggling.

In 2005, not long after I was at a more stable weight, I was running on the trails near my house and met a woman named Tonya. I introduced myself, and we ran together for a while. I would never have guessed that this bright, inviting woman had a dark battle with an eating disorder in her past. To me she came across as a successful mother and career woman. Tonya offered me some excerpts from her past and her views on how she started to recover. I was shocked to know that during her darkest periods, she had used Ipecac to induce vomiting. It was only when she was pregnant that she was able to fully address her bulimia. As is often the case, those of us with eating disorders are more willing to stop certain behaviors in order to prevent harm to others. Eventually we learn that it’s okay to be kind to ourselves, too. Before Tonya reached a healthier point in her life, she captured her despair in her journal entries, offering insight into the depression and overwhelming feelings she continually dealt with during those hard times. It’s amazing to see how strong and confident she comes across now when reading the following, an account of her life in her own words and bits of her personal journal while she was struggling:

I had an eating disorder for fifteen years, twenty if you count the years I continued to relapse. Somehow, through it all, I finished college and graduate school, traveled abroad and kept jobs. I think the severity and length of my illness had to do with my secrecy. When I finally opened up to receiving help, I found the wrong help and fell into another addiction. Finally, in my thirties becoming a mother helped me break free of addiction and I sought therapy to piece together my broken self-esteem.

I dieted to lose weight between age 11 and 13. The pediatrician discovered my weight loss and found I was anemic so he told my mother to give me milkshakes and iron-fortified cereal. Once my mother became interested in my eating, I became secretive. When I was 12 years old and weighed 80 pounds, I wanted to lose weight without anyone noticing. I was proud of my self-control.

August 3, 1978

“Mommy keeps telling me I haven’t been seeing enough of my friends lately. I don’t care. Sometimes I feel trapped when I play with a friend, because I realize there probably isn’t anything better to do. Today she mentioned it so I called Lynn. (She said she’d call me tomorrow.) She couldn’t play, but Francine came over and we went swimming.
Many people keep telling me “you’ve gained some weight there, Huh?” I haven’t noticed any visible change since the Dr. told me to eat more. I don’t want to look fat at all! I want to lose the weight I gained but I don’t want anyone to know. If people notice I gained weight they may also notice if I lose it.”

By high school, repeated diet failures led me to binging, which led to a pitiful self-esteem. I was hopeful and optimistic when I fasted, exercised, or took laxatives. I could lose 5 pounds in a week and feel wonderful, then gain it all back and feel rotten. My weight fluctuated from 115 to 145. When I first read about bulimia, I disregarded the disease. I thought purging was a great idea and I succumbed. Bulimia was different from anorexia because I completely lost control of my eating. I had a diagnosable and treatable problem, but I kept it a secret.

When I went to college I was finally free of the watchful eyes of my parents and had the freedom to totally give into my dark desires to binge and purge. When most students left for fall break my freshman year, I stayed behind in the dorm. I tried to lock myself in my room with no food in an attempt to gain control over my binging. Over the years, with unlimited food in the dining halls, I became severely bulimic. I was binging and puking twice a day and sometimes more. I felt like I had ruined my life and wished someone would save me from myself.

My first attempt to get professional help failed. I let out my secret in an eating disorders support group. I admitted that during my bulimic episodes I turned into a zombie and completely shut out reality. I would walk in a trance to various dining halls where I hoped not to be seen by anyone I knew. I found corner seats and hid embarrassing amounts of food behind the college paper. My mind was numb as I ate. Then in a panicked state, I roamed from bathroom to bathroom seeking privacy. I learned I wasn’t alone in this behavior!  I imagine the other girl-zombies wandered the campus every evening like I did. We respected each other’s privacy since we couldn’t help each other. All I learned from the support group was that Ipecac could induce vomiting.

March 3, 1987

I’ve discovered a miracle drug. It’s so good I might die from it.
In 15 minutes the foul-tasting almondy syrup will coat the walls of my stomach, completely surrounding the partially chewed up crap that I inhaled at the co-op. And Pow, I will feel it in my throat. I’m waiting patiently, calm. I know this shit is reliable. I’ll puke up my guts! I feel it coming on.

When I graduated college I moved to Colorado. I found an alcoholic and manic-depressive but very intelligent boyfriend. He was 13 years older and had five kids in another state. The relationship was sick but I finally had someone whom I could speak openly to about my dark secret. He loved me and accepted everything about me, including my bulimia. I could tell him how painful it was to have to rush off to work with hard pieces of toast up my nose from puking and he would sympathize. It even became a toast-up-the-nose loving joke between us. This intimacy was the first step in my recovery. I binged and purged less frequently. Unfortunately, I replaced my own out-of-control feelings with the chaos and abuse of a sick partner.

I met another alcoholic when I was 28 and once again, there was never a dull moment. He was handsome and charming, and full of anger from an unfair childhood. When I told him about my eating disorder, he didn’t comprehend it or care.  By this time it didn’t matter that he didn’t understand – my eating disorder wasn’t so important anymore. I had new problems. I was pregnant, we were broke and he was bouncing checks to buy beer. I knew this wasn’t the way my life was supposed to unfold, but my self-esteem was still the pits. While I understood that I couldn’t control his alcoholic rages, I wondered how this man had so much control over me.

Like my boyfriend’s love helped me break free from bulimia, my infant son helped me break free from my second neurosis – codependency. Alcohol and babies don’t mix. It was a matter of survival.

I saw a therapist when I was in my early thirties. I confessed to occasional bulimic episodes in which I felt extreme maternal guilt. The therapist predicted that I’d grow out of my eating disorder. I grew into other things so that my eating disorder is a smaller part of who I am.

There was a time when I visualized myself recovered from my eating disorder: I would have a perfect, healthy, athletic body that looks good in a bikini. People would look at me and see a healthy person who has no problem with weight or body image. People would wish they had my eating habits when they’d watch me take healthy portions of all the right foods – and stop when I’m full.

I can’t say recovery had too much to do with conquering food and achieving bodily health. Rather healthier eating was a consequence of regaining the parts of myself that didn’t have to do with food or my body. I took pride in parenting, took a new interest in relationships, and made some accomplishments in my career. I even looked back on some of my accomplishments of the past and appreciated who I was. I had a lot of endurance!  I am very sad that I wasted so much time and energy in my life, but I hope I’m a more empathetic person as a result. Bulimics experience emotional extremes. At good times I believe these extremes make me live fuller and deeper. I developed ways to release my emotions without throwing up. For one thing, I run.

Yesterday a friend lamented over a former boyfriend who always shopped and cooked for her. “It was wonderful,” she said. She likes a man who cooks. I said very naturally, that I have an eating disorder and wouldn’t want a man who cooked for me because I’d feel stressed out by the obligation to eat the food he made. I’m happy my boyfriend is not a cook or big into food.

I have my idiosyncrasies. For example, I won’t eat doughnuts because that was a binge food and I eat cheese and crackers late at night when I want that comfort. I think the boyfriend conversation yesterday is a real statement about my recovery. Saying I have an eating disorder isn’t hard for me. It’s no longer a dark secret. I’m not ashamed.

Like Tonya, I have my peculiarities with food that seem to have lessened over time. However, I am aware now that these are normal. Even the most grounded human beings occasionally eat for comfort or avoid certain foods. Sometimes there is a fine line between what is considered normal and what is considered pathological behavior. With more people developing orthorexia, that line can be difficult to define. Orthorexia is a condition in which a person becomes overly focused on eating foods perceived to be pure, clean or healthy. The obsession can be taken too far and develop into a case of anorexia. For me, the answer lies in that which supports my health. If an odd behavior is interfering with my well-being, general health or happiness, it’s time for a change. When I notice that I’m overly focused on food or my weight, I have to ask myself what’s underneath it. What stress or emotion is at the root of causing me to obsess again? Once the feeling or emotion is addressed, it’s easier to let go of the obsession.

* * *

Training on Empty: Chapter 14 (Possible TW)

Possible trigger warning with mention of behaviors and numbers.

PART II – Black

Chapter 14 – The Comeback

“The body does not want you to do this. As you run, it tells you to stop but the mind must be strong. You always go too far for your body. You must handle the pain with strategy...It is not age; it is not diet. It is the will to succeed.”  – Jacqueline Gareau, 1980 Boston Marathon champion

The relationship between coach and athlete is a deep and complicated affair. It takes great skill on the part of a coach to show unconditional support to an athlete and view the athlete as a whole person, not only as an athlete. The only way this can occur is if the coach has no emotional attachment to the performance of the athlete. Focusing more on the athlete’s health than on her performance is rare, but once a coach looks beyond the end result to the athlete’s higher good, he can expect greatness. A coach who uniformly equates good performances with success, on the other hand, is courting disaster. Unfortunately, this is the most common type of coaching – from gymnastics to swimming – and while it may produce short-term success, it does not allow for long-term healthy careers in sports. I even heard of one runner whose coach made her get off the airplane ahead of him, because he called her performance at the Olympics an embarrassment and he no longer wanted to be associated with her. Once a coach realizes that his athlete thinks the world of him, it’s very tempting to push her to her limits instead of allowing her talent to emerge slowly.
Somehow I got it into my head that there was an unspoken agreement between my coach and me that more was better. When he would tell others I couldn’t run easy or always did more than I was told, I took it as a compliment, that I should continue to push the envelope when I ran. My coach called himself sensible when it came to training. He had led several teams to state victories and several individuals to state titles. I sometimes heard other runners talk about running programs that were a little on the insane side, so in comparison, our program did seem sensible. Once, while warming up for a race early in my high-school career, I met a girl from another team who was the perfect example of how not to train. She told me her coach had her run a race a week ago on Saturday, do intervals that following Monday, run a hill workout Wednesday, and do a time trial Friday, and now here she was warming up for the race on Saturday. She finished far back in the pack, behind most of the girls on our B team. She was obviously fatigued before the gun even went off. My coach was careful to keep us from doing hard workouts too close to race days, but at the same time there was an enormous amount of pressure for us to perform. In addition, ours was a high-mileage program with no complete days of rest.

I didn’t find out until later that nearly every top cross-country runner at Fairview had some sort of eating disorder. There were other girls on rival teams who also looked far too thin. Most of the girls on the team during my senior year struggled with food issues. Two girls on that very team developed severe anorexia later in life that nearly killed them both. My coach was never overly vocal about weight, but he made some definite implications that you had to be thin to win. For some reason, it seemed reasonable to him that girls standing 5’3” tall could retain health while weighing under 100 pounds. A friend of mine on the B team was told that if she lost weight, she would have a better chance of making varsity. She was 102 pounds at the time.

As I sat in the hospital with my fractured pelvis and growing fears of gaining weight as a result of not running, the thought occurred to me that I might never run again. I tried desperately to push these thoughts away, but they would continually creep back and terrorize me. Once, when I was a sophomore, my coach told his friend that inevitably when a girl runner becomes a senior, she gets fat and quits running. I was standing right there when he said it. In a grand effort to prove him wrong, I decided that if I was at risk for losing the ability to run, at least I would not gain weight.

My hospital stay was only a week long, but should have been longer. I weighed 94 pounds upon entry and by eating one meal a day and occasionally throwing up dessert. It was the first time I made myself throw up since that one awful afternoon shortly after I first became anorexic and my mom insisted I eat that hard-boiled egg. It seemed almost sensible to throw up at the time, even though I knew it couldn’t be good for me. Instead of being discharged from the hospital, I left against medical advice. I walked out the door weighing 92 pounds. The head psychiatrist wanted to keep me in the hospital until I gained weight. His methods of treatment did not sit well with me. He wanted to reward each pound I gained with an increase in the amount of freedom I had. He called this “behavior modification”; I saw it as his way of trying to control me. I called my parents and told them I wanted out, that I needed out. I begged them to get me out and informed them that this was not the place for me, my peers being drug users and dropouts. Eventually, I convinced them I would continue to rest and get better on my own. I was still honing my manipulation skills despite my increasing if reluctant awareness that I was too thin.

After several days at home, I woke up one morning not feeling quite right. I stood up and started to walk out my bedroom toward the hall only to find that the room was spinning. I grabbed for the wall in an attempt to stay upright. The thud against the wall woke up my mom, and she came rushing to my side. I had nearly passed out. We both knew it was from lack of food. She coaxed me to try and eat something, and I cried as I accepted a bowl of cereal. Tears streamed down my face as I spooned the cereal into my mouth, yet at the same time I allowed the food to soothe my frayed nerves and tired body that had been crying out for nourishment for so long. I felt a little better after eating, but there remained the problem of my injury.

Sometimes in life one is lucky to have someone reach out or make a difference. Several times now, I have been so lucky. When Lisa, a good friend of mine who just happened to be my rival from another high school in Colorado, heard that I was injured, she went to talk to her coach. I suspect she was also struggling with anorexia, but it was something we never discussed. She was at least as thin as I was and had odd eating habits, like peeling long strips of the inside of a banana peel off to eat slowly before she ate the banana itself. She had heard that the inner peel of the banana contained a great deal of nutrients. The entire process was mesmerizing and took an astonishing 15 minutes to complete. It was the slowest consumption of a banana I had ever witnessed. Lisa’s coach told her that without me there to compete, her chances of winning state in cross-country the next year were excellent. She told him the win wouldn’t mean anything if I wasn’t there, and in a gesture so unbelievably kind and caring she came to visit me, get-well card in hand. I was at home, out of the hospital, but I was still not running. I was in tears as I explained that the doctor had said I might never run again. With two full weeks of rest, my bone still ached when I walked. Lisa took my hands in her own and said not to worry. She knew I would be back and, in that moment, planted a seed of hope that would germinate in my mind until it grew into reality.

A month and a half later, eight extra pounds on my still small frame and worry suffusing my soul, I went to see my coach. I told him I was sorry for not listening to him and that I wanted to work with him again. I assured him I could lose weight, and he said that with good training the weight would take care of itself. At 100 pounds, I hardly needed to lose weight, but I had raced well the year before at a lower weight. I assumed that my coach’s comment meant that with training, my weight would drop. Immediately, I felt fat. I promised I would do whatever he said. I had learned my lesson. I did not mention I had developed a little problem of occasionally binging and purging.

Winning a 5K in high school.

* * *

After speaking to Lori Fitzgerald's mother recently, I felt it was OK to let people know that I used the name Lisa in place Lori. Several other names have been changed throughout this book, but this is one I wanted to share, as Lori was a remarkable and unbelievably kind individual.